Mastectomy - Surgical Breast Removal

What Is a Mastectomy?

A mastectomy is a surgery that removes all breast tissue from one or both breasts. It is used to treat many types of breast cancer and also helps prevent cancer in people who have a high risk.

There are different kinds of mastectomies, depending on how much breast tissue needs to be removed. Mastectomy is different from lumpectomy (partial removal of the breast or just removing the tumor). You are free to choose whether you want breast reconstruction after the surgery. Your doctor will explain every option and help you decide what is best for your treatment plan.

Having a mastectomy is a very personal choice and will bring up many emotions. You may feel worried but also determined to remove the cancer. You might also feel sad about losing your breast, as it feels like losing a part of yourself. All these feelings are completely normal, and your doctor will support you throughout the process.

What Types of Breast Cancer Does a Mastectomy Treat?

A mastectomy is a surgery used to treat different types of breast cancer, such as:

• Infiltrating ductal carcinoma (a common breast cancer that starts in milk ducts).

• Paget’s disease (abnormal bone remodeling causes weakness, pain, and deformities) of the breast.

• Infiltrating lobular carcinoma.

• Inflammatory breast cancer (it is an aggressive cancer causing redness, swelling, and warmth).

• Triple-negative breast cancer that does not respond to hormone-based treatments.

What Are the Different Types of Mastectomies?

Mastectomies are grouped by the amount of breast tissue removed during surgery.

The main types of mastectomy are the following:

• Partial Mastectomy: It removes the tumor along with a small amount of normal tissue around it. This is usually done for early-stage breast cancer.

• Total Mastectomy: It removes the entire breast but keeps the chest muscles underneath. It is done on one or both breasts.

• Bilateral Mastectomy: A bilateral mastectomy removes all the tissue of the breasts on both sides. It is often recommended when cancer is present in both breasts or if there is a high risk of cancer developing in the future.

• Nipple-Sparing Mastectomy: A skin-sparing or nipple-sparing mastectomy involves removing only the breast tissue while keeping most of the skin and sometimes the nipple area, which helps in breast reconstruction.

• Mastectomy With Breast Reconstruction: Breast reconstruction surgery can be done during mastectomy or later as a separate procedure. This involves reconstruction of the nipple and areola, depending on the treatment plan.

• Modified Radical Mastectomy: It involves the removal of the entire breast, including the lymph nodes under the arm. It is done when cancer is likely to spread to the surrounding lymph nodes.

• Radical Mastectomy: All the breast tissue, underarm lymph nodes, and the pectoral muscles beneath are removed. Though rarely performed today, it may be necessary if cancer has spread to the muscles. Apart from this, there is a single mastectomy, where one breast is removed, and a double mastectomy, which is nothing but the removal of both breasts. All breast removal surgery is done by specialized surgeons.

How Can I Get Ready for a Mastectomy?

Your treatment depends on the type of mastectomy and reconstruction and helps you prepare for recovery.

Preparing for breast removal surgery includes:

Preparation Steps:

• Quit smoking to improve healing and increase your chances of being able to have reconstruction.

• Follow your doctor's fasting instructions before surgery.

• Plan for help with work, household tasks, and meals, as you may need to stay in the hospital for at least one night.

Recovery Tips:

• It is safe to avoid lifting heavy objects or raising your arms above your head after surgery.

• Keep commonly used items within easy reach.

• Arrange for someone to help you at home during the first few days.

Support Groups:

Talking to people who have gone through a mastectomy will help you feel more prepared and reduce your stress.

What Happens During a Mastectomy?

During a mastectomy, here is what usually occurs:

• Anesthesia: You will be given general anesthesia so you sleep through the surgery. A breathing tube and an IV (intravenous) will be used, and for longer surgeries, a urinary catheter may also be placed.

• Preparation: The area on your chest will be cleaned and sterilized. You will also receive IV antibiotics to help prevent infection.

• Lymph Node Identification: Your surgeon may inject a small amount of blue dye or a mildly radioactive tracer to help locate nearby lymph nodes. The blue dye temporarily changes the color of your urine and may stay in your tissues for a few weeks.

• Breast Tissue Removal: The surgeon removes the breast tissue. Depending on your treatment plan, some skin or the nipple may be preserved. Additional tissue may be taken if the cancer has spread.

• Lymph Node Removal: One or more lymph nodes from your underarm may be removed for testing. In some cases, all underarm lymph nodes are taken out (axillary lymph node dissection).

• Reconstruction: Breast reconstruction might be begun or completed during the same surgery. This may involve implants, a tissue expander, or tissue taken from another part of your body.

• Closure: If reconstruction is not done immediately, the surgical site is closed. You may choose to have reconstruction later or not at all.

• Drains: A small drain may be placed to remove extra fluid from the area. It is connected to a collection bulb and usually stays in place for one to two weeks.

What Happens After a Mastectomy?

• After surgery, you may need to stay in the hospital for one night or longer if your procedure was more complex. Walking on the same day is encouraged because it helps prevent blood clots and pneumonia.

• Your doctor and the involved medical team will show you how to care for your wound and surgical drains at home. Pain after mastectomy is managed with painkillers. Laboratory results usually come back within a couple of weeks and will confirm whether the cancer was completely removed. In rare cases, another surgery is needed.

• If any cancer cells remain, treatments like radiation or chemotherapy are recommended. Some people finish these treatments before having breast reconstruction. Additional surgeries may be done later to adjust how the reconstructed breast appears.

What Are the Benefits of a Mastectomy?

Mastectomy comes with several benefits. A few benefits of mastectomy are the following:

• It removes the entire breast tissue, helping eliminate cancer cells.

• Since most of the breast tissue is removed, the chance of cancer recurring in the same breast becomes less.

• In high-risk cases, people with a strong history or genetic mutations, a preventive mastectomy will help reduce the risk of cancer.

• In some people, mastectomy helps avoid radiation therapy after surgery. This prevents the damage caused by radiation exposure.

• Mastectomy is generally recommended for you if you have large tumors in one breast or when cancer returns after treatment.

• Some people may feel relaxed knowing that most breast tissue has been removed, reducing the risk of future cancer.

• Mastectomy allows you to choose breast reconstruction during the same surgery or later to restore the shape of the breast.

What Are the Risks or Complications of a Mastectomy?

All surgeries, mastectomy included, carry some level of risk. Early complications include wound infections in fewer than one percent.

Complications include:

• Hematomas (blood collection outside vessels, causing swelling, pain, and discoloration).

• Seromas (a fluid buildup under the skin after surgery, causing swelling).

• Flap necrosis (due to a lack of blood supply, the tissue under the flap dies), all of which require further treatment by nature.

• Delayed issues might consist of post-mastectomy pain syndrome.

• Nerve damage leading to pain or tingling.

• Lymphedema (swelling that is caused by damage to your lymphatic system).

These concerns should be addressed by your treating doctor.

What Is the Recovery Time?

The recovery time for a mastectomy varies. Most surgical wounds take three weeks to heal, and they may also end up in mastectomy scars. But soreness and stiffness in the arm, chest, and shoulder last up to six weeks and will improve with mild pain relievers and prescribed exercises.

Apart from this, double mastectomy scars or double mastectomy recovery may take quite some time to heal. Fatigue, numbness, twinges, or phantom sensations in the chest may occur as nerves take months to heal.

Conclusion

Mastectomy surgery is a very invasive procedure that may have effects on a patient's body, emotions, and psychology. You must discuss the various options with your doctor before making a choice, considering that there are possible risks and benefits associated with a mastectomy.

Emotional support and counseling may also reinforce recovery and help patients cope with changes in the body and the psychological challenges that may ensue. To learn more about mastectomy, ask a doctor online about its procedure and benefits.

Key Takeaways:

• Mastectomy is a surgical procedure to remove one or both breasts.

• It comes in different types depending on the type and stage of cancer.

• Preparation and recovery tips will help overcome the mastectomy process.